Mid-Week ObamaCare© Implementation Update

First up (and as previously noted but now confirmed), Aetna will no longer write so-called "child-only" plans. These have been useful in, for example, divorce situations and some group-based scenarios, and are now off the table insofar as Aetna's individual medical plans are concerned. While this may not seem to be a big deal, it's a further erosion in the choices available in the (previously) open market.

This change is effective October 1st for Kentucky and Indiana, and November 1st for Ohio.

If you're tuning in late, these changes are a direct result of ObamaCare©'s careless and destructive assaults on basic risk management principles. For example, the new regs prohibit underwriting on "children" 19 years and under, which, according to the folks at Aetna, "have the potential to significantly increase the cost of premiums and make coverage unaffordable." Quite so.

On the other hand, Medical Mutual is poised to pick up at least a few of Aetna's minors:

"Medical Mutual will continue to accept applications and provide quotes for plans with effective dates of September 23, 2010, through October 31, 2010, for children under the age of 19 (either as a stand-alone product or as part of a family)."

Of course, no one really knows what's going to happen going forward from October. As the folks at MMO told us in email, "the Company reserves the right to withhold final approval based on clarification of state and federal regulations on individual plans or not issue a policy at all."

How's that for Hope and Change?

UPDATE: And this just in from United Healthcare's Golden Rule:

"In previous communications, we had informed you of an impending change to the coverage effective date that would take place on September 1, 2010. Due to broker feedback, this date has been moved to September 6, 2010."

Interesting that they received, and acceded to, what must have been fairly intense pressure from agents.

So beginning with new applications received on or after next Monday:

"Coverage effective dates for Golden Rule renewable health plans will be the later of 30 days after an application is received or the date requested by the customer (but no greater than 60 days)."

Glad they cleared that up.

Oh No She Din't!

(That's not a typo - it's yours truly trying to be "hip")

Maybe she just can't help it, but HHS Secretary Shecantbeserious just doesn't quite "get" why those of us who oppose the train-wreck that is ObamaCare© might take some slight umbrage at this:

"So, we have a lot of reeducation to do" [emphasis added]

For those historically-challenged readers, here's why it's so offensive, and telling:

"The re-education camp remained the predominant device of social "control" in the late 1980s. It was used to incarcerate members of certain social classes in order to coerce them to accept and conform to the new social norms."

Looks like Kathy let the ol' mask slip.

BlogRoll Update

I've been meaning to add Andrew Garland's entertaining and enlightening blog for some time, and am pleased as punch to have finally done so. You'll see the Easy Opinions link about 5 spots down from the top (look for the "NEW!" tag), and I heartily recommend clicking through.

You'll be glad you did.

Wolverines jump in the pool [UPDATED]

[Please scroll down for update]

"Michigan is set to launch a subsidized insurance pool for people who haven't been able to get coverage because of a pre-existing health condition, but it's not clear if the program will be big enough to handle everyone who wants to buy in."

Really?

"[B]ig enough to handle everyone who wants to buy in[?]"

One supposes that they honestly believe that they'll attract more than, say, New Jersey, but I'm not convinced. In order to be eligible, ObamaCare© requires that one be uninsured for at least six months, and (of course) be "uninsurable." In the event, the Grand Opening is tomorrow (August 31st), and officials estimate that there are some 3,500 Michiganders [ed: Michiganders?] who may qualify. As with Pennsylvania, coverage doesn't begin immediately; the earliest available effective date is October 1st.

Michigan has been given some $140 million as seed money for their version of the ObamaPool©, which tracks with Pennsylvania's $160 and Ohio's $150 million. They're also counting on folks ponying up anywhere from $200 to $700 a month in premiums (which are age- but not sex-rated). And of course it's a typical, generic co-pay plan (aka Phantom Insurance), which will increase utilization and, hence, costs. How much different (read: better) such plans would work if they were built on an HSA high deductible chassis. But we can't have that pesky personal responsibility component, can we?

There is, however, some good news: this plan, unlike some others, does not count a current pregnancy as a qualifying pre-existing condition (I confirmed this with the folks running the program). That should help delay the inevitable financial melt-down.

On the other hand, though, is this world-class non-sequitor:

"Plan administrators say the coverage will be more comprehensive and in many cases less expensive than typical Michigan policies for individuals."

Hunh?! More coverage at lower rates? Guess who pays for that?

But it gets better (or worse, depending on one's perspective):

"Many of those who will be in the plan aren't able to get commercial coverage at any price because they're so expensive to insure."

Let's see if I follow this: "more" coverage at "lower prices" for folks who can't get health insurance in the open (competitive) market because they're too "expensive" to insure.

Only in Lansing (or DC) could someone say that with a straight face.

[Hat Tip: FoIB Holly R]

[UPDATE]: While we've had our issues with Best's insurance ratings services in the past, they're still the "go-to" folks when trying ascertain a carrier's financial outlook. And based on Best's analysis, one has to wonder what the rocket surgeons in Lansing were smoking when they awarded this little plum:

"[Physicians Health Plan of Mid-Michigan]

Financial Strength Ratings
Rating: NR-5 (Not Formally Followed)
Outlook: Not Applicable
Action: Affirmed
Effective Date: May 21, 2010"

A rating of "NR-5" means that this carrier isn't even on Best's radar. Does this mean that the company's on the rocks? Of course not, but it does give one pause: after all, a carrier's financial ability is only as good as its underlying strength.

Or apparent lack of thereof.

Gift Ideas...

And then you can give her a colonoscopy for Christmas...

Maxine on Healthcare

[Welcome, Investor Village readers!]

From the mailbag:

[IMAGE OF "MAXINE" REMOVED AT

REQUEST OF TM HOLDER]

Let me get this straight. We're going to be "gifted" with a health care plan we are forced to purchase and fined if we don't,

written by a committee whose chairman says he doesn't understand it, passed by a Congress that hasn't read it but exempts themselves from it,

to be signed by a president who also smokes,

with funding administered by a treasury chief who didn't pay his taxes,

and financed by a country that's broke.

Now, honestly just ask yourself, what could possibly go wrong?

[Hat Tip: FoIB Laurel L]

From the mailbag: MassTravelers

"My husband and I are residents of Massachusetts. We will be quitting our jobs and traveling outside the country for several months. I hadn't planned on using COBRA since we will be out of the country and using travel insurance that covers other medically and otherwise. I am concerned about being fined for this. Is there a way to avoid fees if we can prove we are out of the country?"

This is a great question, with ramifications beyond Massachusetts. ObamaCare©'s (evil) mandate will have the same effect, and will of course affect Americans in the other 56 states, as well. It does seem unfair to require someone who's out of the country for an extended period to purchase insurance they probably won't need.

I contacted the Bay State's Department of Insurance, and was told that, if one is uninsured for less than 90 days, then it's not an issue or a problem. If it's more than 90 days (and it appears that this reader will, in fact, be gone longer than 3 months) then the fine is assessed. However: there's an exemption for folks who were uninsured because they were out of the country (such as our reader). These folks would have to file a special appeals form, but I was assured that this is not a big deal and that the fine would be waived.

The email continues:

"Also, when we return what is our best option for becoming insured if we do not become re-employed full time right away?"

I replied that, once they're back stateside, they can go online to the MassCare Connector to find coverage. Of course, the challenge there will be finding a plan that fits the budget and coverage goals, but is apparently the only real option left to Bay Staters in need of individual coverage.

That deals with the MassCare issue, but not the ReaderCare one. As Bob points out:

"Leaving the country with coverage allows you to have benefits around the world. Even if she is not traveling to a Schengen Convention country, at the very least she needs an international travel policy to supplement the back home stuff. If she relies on something like IMG alone she is exposing herself to some serious potential out-of-pocket.

Seems to me like she is willing to roll the dice and assume she won't need the US based coverage while out of country and assumes she can pick back up where she left off when she returns. Romneycare does not have waiting periods but it doesn't mean she won't come back and be able to get immediate coverage."

Something to consider.

Cavalcade of Risk #112: Med School edition

Ever wondered what it would be like to go to medical school? Well wonder no more. The first year med student behind the Notwithstanding blog takes this week's Cavalcade of Risk to class. Don't be late!

Bleg: We need a host for the 10/6 Cav - please drop us a line to claim it.

Running up the score...

As housing sales plummet, it may be instructive to draw some parallels:

"Sales of previously occupied homes plunged last month to the lowest level in 15 years, despite the lowest mortgage rates in decades and bargain prices in many areas."

Try this:

"Sales of new high risk pool insurance plans plunged last month, despite the fact that they are readily available and require no underwriting."

Moving on:

"The irony is that, in failure, the GSEs (Fannie Mae and Freddie MAC) have become more important than ever. Private lenders, which once regarded a mortgage secured by a home as a highly safe investment, now see it as highly risky."

Versus:

"The irony is that, in failure, ObamaCare© has become more important than ever. Private insurers, which once provided insurance to some 85% of those not insured by the government, now find themselves unwilling to issue plans on children because of onerous underwriting handicaps."

Of course:

"This means that sudden withdrawals of support might deepen housing's depression."

Or:

"This means that sudden withdrawals of plans and carriers from the market might lead to even more uninsured."

Shall we go on?

Let's:

"The single-minded promotion of homeownership failed and, paradoxically, undermined the American dream."

Meaning:

"The single-minded promotion of providing health insurance to an additional 10-13% of Americans has failed and, as intended, undermined the American dream."

That about sum it up?

[Hat Tip: Ace of Spades]

Grand Rounds: The Cartoon edition

Laughter, they say, is the best medicine (although I prefer penicillin). This week's Grand Rounds illustrates that theory, to great effect. Stop by for a smile and some great info.

Lexis-Nexis Insurance Community: Special Announcement

Sharp-eyed readers may have noticed a slightly different Lexis-Nexis badge in our sidebar. After much deliberation, the folks at that august organization have confirmed InsureBlog as one of the Top 50 Insurance Law Blogs for 2009 (yeah, they're a little slow, but they're lawyers...).

We’re proud as punch, especially since it’s “on the merits” and not an internet voting arrangement.

Click here for the complete list.

Just to clarify: The 2009 appellation includes the current year – this isn’t “old news.”

More from the "I Told Ya So" files

So much for the health care, er, insurance "crisis::

"Just two people in New Jersey will begin receiving coverage Monday under new plans created by federal health care reforms."

The Garden State's new Risk Pool - like those in other states - requires one to have been uninsured for at least six months in order to be eligible. The plans are age-rated, and come in two flavors, neither of which, apparently, are palatable to New Jersey residents who might otherwise qualify.

This should come as no surprise; as we noted long ago, folks are reluctant to sign up for these kinds of plans, even when they're free, let alone upwards of $800 per month. And it's not for lack of interest:

"[M]ore than 600 applications were downloaded and 268 information kits were sent out" once the plan went online at the beginning of the month. Yet only two such plans were actually purchased.

Let me repeat that: only two such plans were actually purchased.

While it may be a surprise to gummint types, we agents have known all along that insurance is rarely purchased: it is sold. Of course, this point is lost on the folks in DC (and state capitals).

Gee, wouldn't it be nice if there was some existing distribution channel to help folks make this purchase?

From the mailbag: About ObamaCare© and your W-2

No blog (or bloggers) hold ObamaCare© in more contempt than IB, but we have been (and continue to be) scrupulously fair in our criticism of this train-wreck. In that spirit, it seems necessary to debunk an email currently making the rounds (in fact, there are several versions) which goes something like this:

"Beginning in 2011, employees covered under their company's health insurance plan will see the value of that plan reflected on their W-2's, and they will owe taxes on that value."

Wrong on three counts:

First, the relevant portion of Obamacare© doesn't take effect until 2018.

Second, only so-called "Cadillac plans" are subject to this provision.

And third, there is no "tax" on these benefits. Carriers which continue to sell relevant plans will be taxed on them, and of course no business (including insurers) pays any taxes, so these increases will be passed along. But there's no specific amount that can be imputed to that increase, so individuals won't see it reflected on their W-2's.

There are lots of reasons to oppose ObamaCare©, and of course most people want to see it repealed, but let's continue to base our arguments on the facts.

Your Tax $$ at work

We've discussed the medical benefits of beer before, most recently as a risk management tool against developing prostate cancer.

Unfortunately, it turns out that beer may have other, less helpful side-effects, and it only took two major studies to determine that:

"a few drinks can suddenly make other people seem more attractive -- and receptive -- than they actually are, according to two new studies that help explain the "beer goggle" effect."

No word yet on whether or not "beer goggles" are covered vision-care expenses.

Helpful Carrier Trick

As regular readers know, we've been a leading edge resource for ObamaCare© information. Some folks, though, would prefer to have more details about application of these changes.

Fortunately, Humana has prepared a handy little booklet which should answer most (if not all) of the most pressing questions. It's available here.

As always, we're available to answer more detailed questions; feel free to drop us a line or leave a comment - we'll do our best to provide accurate and timely answers.

Cavalcade of Risk #112: Call for Submissions

The Notwithstanding Blog hosts next week's Cavalcade of Risk. Submissions are due this Monday (the 23rd). Please remember to include:

■ Your blog's url
■ Your post's url
■ The post's trackback URL (if available)
■ A (brief) summary of the post

And PLEASE remember: ONLY posts that relate to risk (not personal finance tips and the like).

You can submit your post via Blog Carnival or email.

We need a host for the October 6th Cav. Help??

Good News/Bad News Thursday

First, the good news, at least for those undergoing chemo for cancer:

"Yale researchers have developed a medication based on a Chinese herbal recipe more than 1,800 years old to counteract the adverse effects of chemotherapy."

I've always had a soft spot for "alternative medicine" (although I've been assured that Frozen Margarita's are not considered such). This "new" protocol is designed to alleviate "gastrointestinal side effects" of a particular chemotherapy med called CPT-11 (aka "Irinotecan"); it's been tested, with some degree of success, on mice. In fact, it seemed to actually enhance the latter's efficacy.

Even though the treatment is derived from a "recipe" that's almost two thousand years old, it's been refined to a point where it can be manufactured in a consistent way. No word yet on when, or even if, it'll be available.

The bad news is for folks who still believe, despite overwhelming evidence to the contrary, that they'll be able to "keep the insurance they have:"



Remember, though, we had to "pass the bill to see what's in it." Dont'cha just love surprises?

HWR: Health Reform Implementation edition

HWR co-founder Joe Paduda hosts this week's Health Wonk Review. It's a great "survey course" on health care policy and polity, especially if you're interested in health care "reform." Do check it out.

Um, about those tax breaks...

You're not getting them:

"Fewer than 2 million of the nation’s 6 million companies with employees qualify for the small-business tax credits included in the new health insurance reform law."

Says whom? Says the National Federation of Independent Business. Now, we've had our issues with the NFIB in the past, but this seems to comport with the fact that there are so many hoops through which to jump that most small business - which the "break" was supposed to benefit - will, in fact, be ineligible.

Why is that?

Here's why. To be eligible, an employer must meet all three of these criteria:

■ have fewer than 10 employees
■ with an average compensation of less than $25,000
■ and pay at least half of their health insurance premium

For one thing, how many employers can still afford to pay for "at least half" of their employees' premiums? I daresay not many. And good luck, by the way, if you're hoping to become the 11th employee at XYZ Widgets, or expect that raise to take you over $25k a year if you're fortunate enough to already work there.

It's far more likely that these employers will drop group cover altogether: that's a lot more cost effective than some potential tax break.

Earlier this week, Bill posted his findings regarding the Kaiser Family Foundation Health Reform Subsidy Calculator, a handy tool for individuals. The NFIB has their own little widget, which can help employers determine whether or not they're in line for this much vaunted tax break.

And what about all those entrepreneurs, both voluntary and involuntary? Well, they're outta luck, as well.

But surely, even without the tax credits, insurance premiums will decline as promised, right?

As will come as no surprise to regular readers, not so much:

[Video Hat Tip: Hot Air]

Is this a leap?

What would you think if the Speaker of the House were to say:

"There is no question there is a concerted effort to make this a political issue by some. And I join those who have called for looking into how is this opposition to [health care reform] being funded ... something we've been working on for decades, something of great interest to our [country] as we go forward to an election about the future of our country."

Would she be referring to folks who object to a major change in how health care is delivered and financed? People like the Cato Institute, or Tea Party participants, or even humble bloggers? Wouldn't that be using the power of the federal government to criticize its critics?

Now, you may be wondering why I would even think that Ms Pelosi would make such an outrageous suggestion. Certainly she would never advocate silencing principled opposition, denying us our 1st Amendment rights?

Right?

Not so much.

Here's what she said yesterday:

"There is no question there is a concerted effort to make this a political issue by some. And I join those who have called for looking into how is this opposition to the mosque being funded ..."

So if she's comfortable threatening those opposed to the Ground Zero Mosque, a position supported by 70% of the citizenry, then why would it be a stretch to believe she feels the same way about ObamaCare©, something opposed by almost as wide a margin?

Funny, it's mid-August, yet I feel a chill in the air.